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COVID-19 and comorbidities of hepatic diseases in a global perspective

Aqsa Ahmad1, Syeda Momna Ishtiaq2, Junaid Ali Khan2

  • 1Institute of Microbiology, University of Agriculture Faisalabad, Faisalabad 38040, Punjab, Pakistan.

World Journal of Gastroenterology
|April 9, 2021
PubMed

Insights

Coronavirus disease 2019 (COVID-19) significantly impacts patients with liver disease, worsening outcomes. This review explores COVID-19

Area of Science:

  • Hepatology and Virology
  • Infectious Diseases
  • Internal Medicine

Background:

  • Coronavirus disease 2019 (COVID-19) poses challenges to healthcare systems, especially for patients with liver disease comorbidities.
  • Altered liver function in COVID-19 patients, often due to hepatitis or cholestasis, is linked to adverse prognoses and poorer health outcomes.
  • COVID-19-associated liver injury can arise from severe acute respiratory syndrome-coronavirus type 2 (SARS-CoV-2) infection, potentially progressing in patients with or without pre-existing liver conditions.

Purpose of the Study:

  • To review and synthesize current knowledge on COVID-19-associated liver injuries and abnormal liver function tests (LFTs).
  • To elucidate the complex interplay between pre-existing liver diseases and COVID-19.
  • To define a pathophysiological framework linking COVID-19, hepatocellular damage, and liver disease.

Main Methods:

  • Literature review and synthesis of recent findings on COVID-19 and liver disease.
  • Analysis of the exacerbating effects of COVID-19 on pre-existing liver conditions and vice versa.
  • Compilation of international clinical care, management, and treatment guidelines for COVID-19 patients with liver disease.

Main Results:

  • SARS-CoV-2 can induce liver injury through direct cytopathic effects on cholangiocytes/hepatocytes, immune-mediated damage, hypoxia, and sepsis.
  • The angiotensin-converting enzyme-2 receptor, highly expressed in liver cells, makes the liver susceptible to SARS-CoV-2 pathology.
  • The precise pathogenesis of COVID-19-linked liver disease and abnormal LFTs remains incompletely understood.

Conclusions:

  • COVID-19 can exacerbate pre-existing liver diseases, and liver conditions can worsen COVID-19 outcomes.
  • Understanding the pathophysiological triad of COVID-19, hepatocellular damage, and liver disease is crucial for patient management.
  • Adherence to updated international guidelines is recommended for the clinical care of COVID-19 patients with liver disease.

Keywords:
COVID-19EpidemiologyLiver diseasePathophysiologyProphylaxis

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